Medicare Set Aside (MSA)

What is a Medicare Set Aside?

A Medicare Set Aside (MSA) is a calculation of medical expenses allocated for life that would otherwise be paid for by Medicare.  The MSA will cover the medical expenses for injuries being resolved in a settlement.

A portion of the settlement funds are, based on the MSA calculated, are placed in a interest bearing account.  The account becomes the primary payer for the medical services.

What happens once a Medicare personal injury settlement is reached?

Once a settlement occurs, there are several outcomes.

  • The plaintiff releases all potential claims against the defendant by signing a full liability release.  
  • If the plaintiff is a Medicare beneficiary, Medicare must be placed on notice of the settlement and alleged injuries released.
  • Medicare will then determine if any pasted conditional payments need to be reimbursed.   

The plaintiff may want to determine if funds from the settlement should be set aside to pay for future Medicare related treatment for the injuries resolved in the settlement.

Estimating future medical costs

Future medical costs may be calculated to determine the damages or value of a case. Costs are calculated by reviewing past treatment, looking at future recommendations, determining life expectancy and if Medicare is involved, identifying Medicare allowable future treatment expenses.

What is a workers compensation MSA?

A Medicare Set Aside (MSA) is a calculation of medical expenses allocated for life that would otherwise be paid for by Medicare. In a workers’ compensation case, the MSA is included as part of your settlement.

A portion of the settlement funds are set aside to pay for future medical expenses related to the released injuries that would otherwise be paid for by Medicare.

Centers for Medicare and Medicaid have set up specific guidelines on how to calculate and administer the MSA account.

 

Question about a Medicare Set Aside?

Why use NuQuest for an MSA

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